Naslov
Prophylaxis of migraine by low doses of gabapentin

Autori
Titlić, Marina ; Lušić, Ivo ; Tonkić, Ante

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstracts of the 8th Congress of the European Federation of Neurological Societies u: European Journal of Neurology 11 (2004) (S2) / - , 2004, 243-243

Skup
Congress of the European Federation of Neurological Societies (8 ; 2004)

Mjesto i datum
Pariz, Francuska, 04.09.2004. - 07.09.2004

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
prophylaxis; migraine; gabapentin

Sažetak
A migrene treatment includes two stages- acute pain treatment and prophylaxsis of migrene. An objective of prophylaxis is to reduce attack frequency as well as the intensity of the pain once attack develops. A whole range of drugs are being used for prophylactic treatment of migrene: beta-adrenergic blockers, tricyclical antidepressants, calcium canal blockers, 5-HT2 antagonists, nonsteroidal anti-inflammatory drugs, anticonvulsants, magnesium compensators. Gabapentin is an antipyleptic of a more recent generation. This NMDA-receptor antagonist reduces presynaptic discharge of glutamates as well as hiperexcitationof neurons. Beside the reported effects, it has been proved that gabapentin reduces the levels of GABA in brain. Gabapentin has also been reported to be efficient in the treatment of neuropathic pain in diabetic neuropathy, postherpetic neuralgia, trigeminal neuralgia, and other complex regional pain syndromes. Randomized, double- blind, placebo- controlled study found gabapentin in 2400 mg doses per day very efficient in prophylaxis of migrene (Mathew NT, 1996). Considering the relatively high daily drug doses, a research was planned in which to carry out prophylaxis with considerably lower drug doses. We wanted to see which effects in the prophylaxix of migrene could be achieved with the minimum daily dose of 900mg of gabapentin. Patients and methods: Five patients aged 41, 5+ 2years were examined. They have been treated for migrene for the last ten to fifteen years. In all patients the number of migraine attacks per month was 10 or more. The drugs used earlier for migraine prophylaxis did not show effective. Severity of pain in migraine attacks was determined by 100 mm visual analogous scale (VAS) before the treatment, after two weeks of treatment, after four weeks of treatment, and finally after six weeks of treatment. During the same time, the number of migraine attacks was also being recorded. Average intensity of pain measured by VAS scale before the treatment with gabapentin was 95mm, and average numbver of weekly attacks was 3. The treatment with gabapentin was carried out in all patients as follows: 300 mg on the first day, 2×300 mg on the second day, 3×300 mg on the third and all the following days. The observation lasted for 6 weeks. Results and discussion: After two weeks of the therapy the mean number of attacks per week was around 2, and the intensity of pain measured by VAS scale was 55+ 2, 3 mm, which was followed by a subjective feeling of considerable improvement. After four weeks of treatment average intensity of pain was 46+ 1, 6 mm measured by VAS scale, while the mean number of weekly attacks was between 1-2. After six weeks of treatment average intensity of the pain was 38+2 mm by the VAS scale, with one or two attacks per week. Conclusion: Preliminary results indicate that even low daily doses of gabapentin, 900 mg per day, have significant effects in the migraine prophylaxis, in the number of attakcs as well as in intensity of pain during migraine attacks. Further studies with larger number of patients are needed.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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